Gene therapy for ischemic heart disease

Abstract Current pharmacologic therapy for ischemic heart disease suffers multiple limitations such as compliance issues and side effects of medications. Revascularization procedures often end with need for repeat procedures. Patients remain symptomatic despite maximal medical therapy. Gene therapy...

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Bibliographic Details
Published in:Journal of molecular and cellular cardiology 2011-05, Vol.50 (5), p.742-750
Main Authors: Lavu, Madhav, Gundewar, Susheel, Lefer, David J
Format: Article
Language:English
Subjects:
Cardiovascular
Cardiovascular therapy
Clinical Trials as Topic
Fibroblast Growth Factors - genetics
Gene transfer
Genetic Therapy - methods
Hepatocyte Growth Factor - genetics
Humans
Ischemic heart disease
Myocardial Ischemia - genetics
Myocardial Ischemia - therapy
Nitric Oxide Synthase Type III - genetics
Oxidative Stress - genetics
Vascular Endothelial Growth Factor A - genetics
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Summary:Abstract Current pharmacologic therapy for ischemic heart disease suffers multiple limitations such as compliance issues and side effects of medications. Revascularization procedures often end with need for repeat procedures. Patients remain symptomatic despite maximal medical therapy. Gene therapy offers an attractive alternative to current pharmacologic therapies and may be beneficial in refractory disease. Gene therapy with isoforms of growth factors such as VEGF, FGF and HGF induces angiogenesis, decreases apoptosis and leads to protection in the ischemic heart. Stem cell therapy augmented with gene therapy used for myogenesis has proven to be beneficial in numerous animal models of myocardial ischemia. Gene therapy coding for antioxidants, eNOS, HSP, mitogen-activated protein kinase and numerous other anti apoptotic proteins have demonstrated significant cardioprotection in animal models. Clinical trials have demonstrated safety in humans apart from symptomatic and objective improvements in cardiac function. Current research efforts are aimed at refining various gene transfection techniques and regulation of gene expression in vivo in the heart and circulation to improve clinical outcomes in patients that suffer from ischemic heart disease. In this review article we will attempt to summarize the current state of both preclinical and clinical studies of gene therapy to combat myocardial ischemic disease. This article is part of a Special Section entitled “Special Section: Cardiovascular Gene Therapy”.
ISSN:0022-2828
1095-8584
DOI:10.1016/j.yjmcc.2010.06.007